Levenback C, Morris M, Burke T W, Gershenson D M, Wolf J K, Wharton J T
Department of Gynecologic Oncology, University of Texas M.D. Anderson Cancer Center, Houston, 77030, USA.
Gynecol Oncol. 1996 Jul;62(1):73-7. doi: 10.1006/gyno.1996.0192.
To survey the surgical practice of gynecologic oncologists regarding the extent of groin dissection for early vulvar cancer.
A 14-item questionnaire was developed and presented to the Annual Meeting of the Felix Rutledge Society. Gynecologic oncologists were asked to describe in descriptive, categorical, and visual terms the groin procedure that they perform as part of management of early vulvar cancers. Three ink-line drawings were created by a medical illustrator for the purpose. Fifty returned surveys were evaluable.
The most commonly performed procedures were removal of the lymph nodes above the cribriform fascia and those medial to the femoral vein (40%), removal of lymph nodes above the cribriform fascia (34%), and removal of all nodes above and below the cribriform fascia (22%). Respondents performing the first procedure termed it "superficial inguinal lymphadenectomy" (40%), "inguinal femoral lymphadenectomy" (25%) and a variety of other names (35%). Respondents performing the second two procedures were much more consistent in the figure and name that they matched with their description of the nodes removed. When respondents were asked to match the figures with categorical definitions based on their understanding of the literature, the figure depicting Scarpa's triangle following removal of the superficial inguinal and medial femoral nodes was named superficial inguinal lymphadenectomy by 24% despite the fact that the femoral vein was clearly visible and labeled.
We conclude that (1) among this group of gynecologic oncologists superficial inguinal and medial femoral lymphadenectomy is the most commonly performed procedure for women with early vulvar cancer and that the procedure is frequently called superficial inguinal lymphadenectomy; (2) publications and protocols on this topic must provide complete descriptions of procedures performed, and investigators must assure that individual surgeons are performing the same procedure; and (3) treatment results with superficial inguinal and medial femoral lymphadenectomy are poorly described and a fertile area for further study.
调查妇科肿瘤学家针对早期外阴癌腹股沟淋巴结清扫范围的手术操作情况。
设计了一份包含14个条目的问卷，并在费利克斯·拉特利奇学会年会上发放。问卷要求妇科肿瘤学家用描述性、分类性和可视化的术语，描述他们作为早期外阴癌治疗一部分所进行的腹股沟手术操作。为此，医学插画师绘制了三幅墨线图。共收到50份可评估的回复。
最常施行的手术操作是切除筛状筋膜上方及股静脉内侧的淋巴结（40%）、切除筛状筋膜上方的淋巴结（34%）以及切除筛状筋膜上下所有淋巴结（22%）。施行第一种手术操作的受访者将其称为“浅表腹股沟淋巴结切除术”（40%）、“腹股沟股淋巴结切除术”（25%）以及其他各种名称（35%）。施行后两种手术操作的受访者在与所切除淋巴结描述相匹配的图形和名称上更为一致。当要求受访者根据他们对文献的理解将图形与分类定义进行匹配时，尽管股静脉清晰可见且有标注，但描绘切除浅表腹股沟和股内侧淋巴结后斯卡帕三角的图形仍有24%被命名为浅表腹股沟淋巴结切除术。
我们得出以下结论：（1）在这群妇科肿瘤学家中，浅表腹股沟和股内侧淋巴结切除术是早期外阴癌女性最常施行的手术操作，且该手术操作常被称为浅表腹股沟淋巴结切除术；（2）关于该主题的出版物和方案必须提供所施行手术操作的完整描述，研究人员必须确保各个外科医生施行的是相同的手术操作；（3）浅表腹股沟和股内侧淋巴结切除术的治疗结果描述欠佳，是一个有待进一步研究的领域。
